Outcomes in Variceal Bleeding Associated With Continuous Octreotide in Patients With Delayed Endoscopy.
| Autor: | Laws, Matthew B., Wahking, Rebekah, Blackburn, Erin, Williams, Whitney, Schadler, Aric, Fritz, Megan Kunka |
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| Předmět: |
ESOPHAGEAL varices
GASTROINTESTINAL hemorrhage CIRRHOSIS of the liver ERYTHROCYTES RESEARCH funding HEMOGLOBINS TREATMENT effectiveness RETROSPECTIVE studies DESCRIPTIVE statistics OCTREOTIDE acetate LONGITUDINAL method ODDS ratio ENDOSCOPIC gastrointestinal surgery MEDICAL records ACQUISITION of data TREATMENT delay (Medicine) DISEASE relapse CONFIDENCE intervals TIME DISEASE complications |
| Zdroj: | Journal of Pharmacy Practice; Oct2024, Vol. 37 Issue 5, p1107-1115, 9p |
| Abstrakt: | Background: Variceal hemorrhage treatment includes endoscopy within 12 hours of admission and octreotide therapy for 2-5 days post-endoscopy. Duration of pre-endoscopy octreotide can be prolonged when intervention is delayed. Objective: This study aimed to evaluate the impact of extended pre-endoscopy octreotide on rebleeding after endoscopy when comparing short vs long durations of post-endoscopy octreotide. Methods: This was a single center, retrospective cohort evaluating adult cirrhotic patients with esophageal variceal hemorrhage admitted between July 1, 2017 and June 30, 2020. Study groups included patients receiving octreotide ≥12 hours prior to endoscopy followed by ≤ 48 (short course) or >48 hours (standard course) after endoscopy. The primary outcome was post-endoscopy rebleeding, defined as hemoglobin decrease of ≥2 g/dL from baseline or the requirement of ≥1 unit of packed red blood cells. Results: Of the 169 patients included, 88 patients received short course octreotide after endoscopy, and 81 patients received standard course octreotide after endoscopy. Twenty-nine (33%) patients in the short course group and 43 (53.1%) in the standard course group experienced the primary endpoint (OR 2.3, 95% CI 1.24 - 4.29; P =.008). Conclusion: Extended pre-endoscopy octreotide may be beneficial in preventing rebleeding when intervention is delayed. Further studies are needed to determine the necessary octreotide duration in delayed endoscopy and varying bleeding risk. [ABSTRACT FROM AUTHOR] |
| Databáze: | Complementary Index |
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